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The White Plague in the City of Angels

Caroline Luce, Author

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Key People - Scientists

Dr. Robert Koch (1843-1910)
Robert Koch was born in the Hanover region of Germany and, according to his parents, taught himself to read at the age of five. He studied medicine at University of Göttingen and, upon his graduation in 1866, entered private practice in Hamburg and then Posen before volunteering to serve as a surgeon in the Franco-Prussian War. He began his career as a researcher after the war when he was appointed as District Medical Officer for Wollstein (now Wolsztyn, Poland).  In a laboratory he built in his home there, Koch began researching anthrax, a disease prevalent in the farm animals in Wollstein. Using a careful method of fixing, staining and photographing bacterial spores, Koch was able to prove that the bacterium anthrax bacilli was the cause of the disease and that it was transferable from one animal to another. His findings were published in a botanical journal in 1876, and earned him an appointment in the Imperial Health Bureau in Berlin. The new appointment afforded him access to a much larger laboratory research space, where he worked with Paul Ehrlich to refine his bacterial staining technique and Julius Richard Petri to develop new methods of cultivating bacterial cultures. These new methods were brought to bear when Koch began his studies of tuberculosis. Based on his studies of anthrax, Koch rejected the notion that tuberculosis was inherited and instead set about to prove it was caused by a bacterium. Within months, he and his colleagues had identified and isolated tubercle bacilli as the cause of the disease and proven it was transferable between animals, findings he published in a paper in 1882. After his “discovery,” Koch’s work on tuberculosis shifted to purifying and extracting tubercle bacilli in the hopes that some form of the bacterium could be used as a pathogen that might cure or prevent the disease. He joined the faculty of University of Berlin and became the Director of the University’s newly established Institute of Hygiene, where he continued to experiment with the bacterium extract, a substance he called tuberculin. Although Dr. Koch’s experiments with tuberculin never proved its efficacy as a cure, the purified protein tuberculin he developed became a crucial component of a new technique for diagnosing the disease in humans, the Mantoux Skin Test (also known as the PPD test), the most effective and widely used method to this day. Dr. Koch was honored with a Nobel Prize for his “discovery” of Tuberculosis in 1905, and spent the final years of his life studying cholera and malaria in India and central and northern Africa. He died after a heart attack in 1910. Click here for more on Dr. Koch.

Dr. Paul Ehrlich (1854-1915)
Dr. Paul Ehrlich was born in the Lower Silesia province of Prussia (part of modern day Poland), into the family of a successful liquor distiller who also was the leader of the local Jewish community. He studied biology at universities in Breslau, Strassburg, Freiburg-im-Breisgau and Leipzig before earning a doctoral degree in medicine in 1878. He began his career as a researcher at the Berlin Medical Clinic where he specialized in staining animal tissue. He experimented with the use of a wide variety of chemicals as dyeing agents, and demonstrated how different chemicals reacted differently to specific parts of blood cells. He was among the first scientists to show that these chemical reactions could allow scientists to use particular dyes to stain specific parts of cells, a technique widely recognized as the precursor to the Gram staining method widely used today. His staining method also proved crucial to the research of Dr. Robert Koch, who worked just a few miles away, and helped lead to the discovery of tubercle bacilli. Dr. Ehrlich was convinced throughout his career that similar specialized chemical serums could be used to treat a variety of diseases. Based on his work dyeing and staining cells, he believed that certain chemicals had special affinities for specific pathogenic organisms and that, if injected at specific concentrations, they would target the specific organisms like “magic bullets.” He tested hundreds of different chemical substances on dozens of bacterial diseases and, with the help of a team of research assistants, successfully developed a toxin-based serum (named Salvarsan) to treat syphilis. He was awarded a Nobel Prize for his syphilis treatment in 1908 and is widely credited with having pioneered the concept of chemotherapy. Dr. Ehrlich’s attempt to develop a similar chemical treatment for tuberculosis, a disease he suffered from for many years, were less successful, and he died before he could find a cure. Warner Brothers Studio eventually dramatized his life in work in a 1940 film aptly titled, “Dr. Ehrlich’s Magic Bullet," which was later nominated for an Academy Award. To view the original trailer for the movie, click here. Click here to learn more about Dr. Ehrlich

Dr. Selman Waksman (1888-1973)
Waksman (nee Zolman Abraham Waksman) was born to Jewish parents in Tsarist Russia in an area known as Pryluka (now part of the Ukraine) and studied biology in Odessa before coming to the United States in 1910. He settled with relatives on a farm in New Jersey and continued his studies at Rutgers College nearby. He earned a Bachelors degree at Rutgers followed by a PhD in biochemistry at UC Berkeley. He then returned to Rutgers as a lecturer in soil microbiology, published a textbook on the topic, and amassed a large group of graduate students to work at his research laboratory there. Together with his students, Waksman isolated and developed dozens of new antibiotics over the course of his career, perhaps the most widely used of which is neomycin, found in topical creams, ointments and eyedrops. But he is most famous for his “discovery” of another antibiotic compound, streptomycin, the first effective antibiotic agent against tuberculosis. Waksman’s “discovery” was actually due to the work of one of his graduate students, Albert Schatz, who was able to isolate and purify a soil based bacterium called streptomyces grisens in 1943 (see his biography below). Thrilled by what Schatz had accomplished, Waksman used his commercial ties to convince the pharmaceutical company Merck & Co. to begin clinical trials to gauge streptomycin’s effectiveness in treating tuberculosis. A successful clinical trial was completed in 1947, at which point Merck & Co. hailed it as the world’s first cure for the white plague, but subsequent trials revealed that patients quickly developed resistance to the drug. Only years later, when scientists combined streptomycin with another treatment developed by Swedish scientist Jorgen Lehmann (see biography below) called para-amino salicylic acid or PAS, did trials prove it to be an effective antibiotic therapy for tuberculosis. Unfortunately, the contributions of both Lehmann and Schatz were overlooked when Waksman was awarded the Nobel Prize in 1952 for having “discovered a cure for tuberculosis.” Waksman used his winnings, and the large royalties he earned from his other antibiotic patents to create the Waksman Foundation for Microbiology in the 1950s. Click here to learn more about Dr. Waksman.

Dr. Albert Schatz (1920-2005)
Schatz was born on a fir tree farm in Connecticut but spent most of his childhood in Passaic, New Jersey. He enrolled in the College of Agriculture at Rutgers University with plans to someday return to the family farm, but instead developed a passion for soil microbiology. After graduating, he was recruited by Dr. Selman Waksman to work in his laboratory and continue his studies, but was drafted to serve in World War Two just months after beginning his work there. During his service in the Medical Corps of the Air Force, he observed soldiers dying from infections resistant to penicillin, one of the few antibiotics available, and became determined to find to new, more powerful antibiotic after being discharged in 1943. When he returned to Rutgers, Schatz focused his work on isolating a soil-based bacterium he called Streptomyces grisen, believing it could be effective in fighting tuberculosis and other penicillin-resistant infections. In quick order, he and his mentor Dr. Waksman successfully refined streptomycin. Schatz completed his dissertation on the topic, earned his PhD, and accepted a position as a researcher in the New York Department of Public Health. He later worked on similar public health-oriented research projects in Chile for the Ministry of Health and the United Nations, before joining the faculty of Temple University in Philadelphia from which he retired in 1981. Schatz's departure from Rutgers initiated a period of personal and professional conflict with Dr. Waksman about who deserved credit for the “discovery” of streptomycin. Schatz had been excluded from Waksman’s patent filings for the antibiotic and denied royalties from the lucrative contract Waksman signed with Merck & Co. While he won some financial compensation, Schatz was also overlooked by the Nobel Committee when they awarded Waksman their prize in 1952. Not until the early 1990s did the Society for Industrial Microbiology and the American Thoracic Society acknowledge Schatz’s role in discovering the “cure” for tuberculosis. 

Dr. Jorgen Lehmann (1898-1989)
Lehmann was born in Copenhagen, Denmark but spent much of his life in Sweden. He received his PhD in physiology from the University of Lund and, after graduating in 1929, accepted a position as associate professor there. He also taught at universities in New York and Denmark before settling in Sweden in 1938 where he served as chief physician and director of the central laboratory at Sahlgrenska Hospital in Gothenburg.  Lehmann chose to move to Sweden at the outbreak of the Second World War so that he could concentrate on his research. He focused much of his early research on isolating and extracting vitamins from organic material and experimenting with their therapeutic effects on disease. He and his colleagues developed a blood-thinning agent called dicumarol in 1941 they used in treating blood clots and venous thrombosis, and then set their sights on developing a similar treatment for Tuberculosis. Two years later, Lehmann had successfully synthesized a compound called para-amino salicylic acid, or PAS, and began testing its effectiveness in inhibiting the growth of tubercle bacilli on patients at his hospital. By 1947, he expanded his clinical trials to five of Sweden’s largest sanatoriums and affirmed the effectiveness of PAS in treating TB. Since the bulk of Lehmann’s research and trials were conducted during the Second World War, much of his work went unpublished until after the war’s end, and scientists working outside of Sweden, including Waksman and his colleagues at Rutgers, did not learn of his success until the late 1940s. But beginning in 1948, when trials of streptomycin began exposing its weaknesses, scientists in England began testing the two drugs in combination. Their studies showed that treating tubercular patients with PAS and streptomycin proved far more effective than using either drug on its own. Unlike Waksman, though, Lehmann never received a Nobel Prize for his “discovery” of a cure for tuberculosis, even though PAS continues to be used by physicians to this day.
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